| NPI | 1053379081 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207WX0107X Ophthalmology, Retina Specialist (Licence: TX K9587) | 
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: IL 0036-098036) | 
| 207W00000X Ophthalmology (Licence: TX K9587) | |
| 207WX0107X Ophthalmology, Retina Specialist (Licence: IL 0036-098036) | |
| Enumeration Date | 2006-05-01 | 
| Last Update Date | 2024-07-23 |